HomeMy WebLinkAbout04-0333REV-1500 E~( + (6-00)
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COMMONWEALTH DP PE NSYLVANIA
DEPARTMENTOFRE ENUE
DEPL280601¥
HARRISBURG,PA 17128-0601
REV- 1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEDENT'S NAME fLAST FIRST, AN D MIDDLE ~NInAL
Stine Alfred W.
DATE OF DEATH (MM~ DD-YEAR) DATE OF BIRTH (MM-DC-YEAR)
01/29/20041 ] 10/27/1915
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
OFFICIAL USE ONLY
FILE NUMBER
21-04-
COUNTYCODE YEAR NUMBER
SOCIAL SECURITY N UMBER
161-18-0405
THIS RETURN MUST BE FILED IN DUPUCATE W1TH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
1.OriglnaIReturn ~*. SupplementalReturn 3. RemalnderReturn pdorto1Z-13-82)
Limited Estate . Future Interest Compromise (date of death after 1Z- 1Z-SZ) 5. Federal Estate Tax Return Required
Decedent Die~ Testate ] Decedent Maintained a Living Trust ~ 8. Total Number of Safe Deposit Boxes
(Attach copy of' wig)~ (Attach copy of Trust)
[] 9.L t gat on Proceeds Received/, ~'~ 10. Spousal Poverty Credit [] 11. elecUonto tax under Sec. 0113IA)
I [ (date of death between 12-31-91 and 1 - 1-95) (Attach Sch O)
t~THi$ ~ECTI~ M~ BEth0 MP~ETED[ ~[C ~ORRES~OND £NCE ~ CONFi[JE[N~iA[~.T~i i NFoRMAT[0N S HOUI~D'BE DIRECTED ~0 ~{
Roger B.'Irwin Es
FIRM NAME (If Applical~e)
IRWIN & Mci(NIGHT
TELEPHONE NUMBER
717/249-2353 I
3OMPLETE MAILING ADDRESS
60 West Pomfret Street
West PomfTet Professional Bldg.
Carlisle, PA 17013
1. Real Estate (Schedule A) (1)
2. Stocks and Bon~s (Scheldu~e B) (2)
3. Closely Held Corporation Partnership or (3)
Sole-Proprietorship
4. Mortgages & Notes Rece vab e (Schedu e D) (4)
5.
Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E) I
6. Jointly Owned Property (Schedule F) 6
[] Separate Billing Requested
7. Inter-V~vos Tran~ ers & ~ sce aneous Non-Probate Property (7)
(Schedule G or L[)
8. Total Gross Ass[ets (total Lines 1-7)
I
g. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Deb s of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total DeductionlS (total Lrines 9 & 10)
12. Net Value of Estlate (Line~ 8 minus Line 11)
13. Charitable and Glovernmelntal Bequests/Sec 9113 Trusts for which an election to tax has not been
made Schedule ~J)
14. Net Value Sub)eot to Tax (Line 12 minus Line 13)
None
None
None
None
5,67~'~7~*
13,56~00
6,052:~ 50
(~)
(13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
t hes ousaltax
15. Amount of Line 14 taxable a p
rate, or transfers ~nder selc. 9116(aX 1.2) 0.00 X .0 0
16. Amoun of Line 14 axableat[inealrate 13,307.95 x .0 /*5
17. Amount of Line 14 taxable at sibling rate 0.00 X .12
18. Amount of Line 14 axable a collateral ra e 0.00 X .15
19. Tax Due I I
OFFICIAL USE ONLY
-~ ~n19,556.90
~h-o
'"~ 6,248.95
13,307.95
(14) 13,307.95
Copyright (c) ZOO0 form software on
(15) 0.00
(16) 598.86
(17) o. 00
(18). o. oo
(19) 598.86
SURE ,TO[~ANSWER ALE QUESTIONS,ON REVERSES DE ANI~ ~0~
The Lackner Group, Inc,
Form REV-1500 EX (Rev. 6 00)
REV- t$08 EX * (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX ETURN
RESIDENT DEC~ENT
ESTATE OF
SCHEDULE E
CASH, BANK DEPOSITS,& MISC.
PERSONAL PROPERTY
FiLE NUMBER
Alfred W. Sttnel SS# 161-18-0405 01/29/2004 21-04-
nclude the proceeds o! Iltlgabon and the date the proceeds were received by the estate. All property jointly-owned with the ricjht of
survivorship must be idisclos~d on Schedu e F.
ITEM II VALUE AT DATE
NUMBERI DESCRIPTION OF DEATH
1 M&T Bani, sa~ings account 320.11
I TOTAL (Also enter on tine 5, Recapitulation) $ 320.11
I (If more space is needed, insert additional sheets of the same size)
Copyright (c) t996 form software on~ CPSystems, lnc. Form REV-1508 EX (Rev. 1-97)
REV- 1509 EX * (1-97) SCHEDULE F
COMMO.WE^L~,OF E,.S~LV^N~^ JOINTLY-OWNED PROPERTY
'NH~nlTANOE ?~
RESIDENT DECEDENT )
ESTAT~ OF ) FI'~ NUMB£R
Al£red W. Stine SSt~ 161-18-0405 01/~9/2004 21-04-
If an asset was made joint Within one year of the decedent's date of death, it must be reported on Schedule G.,
] I
SURVIVINGJOINTTE~ANT(S)iNAME ADDRESS RELATIONSHIPTO DECEDENI
A. Augustus WJ Stihe 13 Northview Drive Son
Carlisle, PA 17013
B.
¢.
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION Of PROPERTY % OF DATE OF DEATH
ITEM FOR JOIN1 MADE include name o f financial Institution and bank DATE OF DEATH DECD'S VALUE OF
I account number or similar identifying number.
tJUMBE~ TENANT JOINT Attach deed for jointly-held realestate. VALUE OF ASSET INTEREST DECEDENTS INTERES
1 A 12/01/~75 4&T Bank, savings account 11,343.57 50.00% 5,671.79
I TOTAL (Also enter on line 6, Recapitulation) $ 5,671.79
(If more space is needed insert additional sheets of the same size)
Copyright (c) 1996 form software only ~PSystems, Inc. Form REV-I$09 EX (Re~. 1 -g7)
REV-1510 EX ~(1-97)
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PEN NSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT I
STAT OP !
Alfred W. Stine SS~/ 161-18-0405 01/29/2004
This schedule must/be completed amd filed if the answer o any of questions 1 through 4 om page 2 Js yes.
FILE NUMBER
21-04-
DESCRIPTION OF PROPERTY % OF
iTEM INCLUDETHENAMEOFTHETRANSFEREETHEIR DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE
RELATIONSHIP TO DECEDENT AN D TH E DATE O~ TRANSFER,
NUMBER ATTACH ACOPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE)
1 Western~Southern Life - 13,565.00 13,565.00
annuity! benleficiaries are
childre~
I
[ TOTAL (Also enter on line 7, Recapitulation) $ 13,565.0O
]' ' (If more space is needed, inser~ additional sheets of the same size)
Copyright (c) 1996 form software only C; PSyste~s, Inc. Form REV-1510 EX (Rev. 1-97)
REV-1511 EX '(I-97} SCHEDULE H
FUNERAL EXPENSES &
COMMONWEALTH OF PENNSYLVANIA
INHERITANCETAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF
Alfred W. Stin SS~) 161-18-0405 01/29/2004
Debts of decedent Imust b4 reported on Schedule I.
FILE NUMBER
21-04-
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1 Hoffman~-Roth~ Funeral Home 5,287.50
B. ADMiNiSTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s / EIN Number of Personal Representative(s)
Street Address
Cit~ I State Zip
· Ye!r(s)Co ~mmissior~ Paid:
~'. Attorney's F~es IRWIN & MeKNIGHT 750.00
3. Family E×empfion: ~~1! decedent's address is not. the same as claimant's, attach e×planafion)
St r e[et Address
Cityl' I State Zip
Relationship of Claimant to Decedent
4, Probate Fee
5. Accountant'! Fees
7. Other Administrative Costs
1 Register ~of Willls - filing fee ' 15.00
I
TOTAL (Also enter on line 9, Recapitulation) $ 6,052.50
(If more space is needed, inse~t additional sheets of the same size)
Copyright (c) 1996 form software only Cl PSystems, Inc. Form REV-1511 EX (Rev.
REV-1512EX +(1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULEI
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, AND LIENS
ESTATE OF I FILE NUMBER
Alfred W. $tine SS~/ 161-18-0405 01/29/2004 21-04-
Include unreimbur~ed medical expenses.
iTEM / I
NUMBER DESCRIPTION AMOUNT
1 Carlisl~ Borbugh - water/sewer ' 15.08
/
2 Penn Powder & Light Co. 33.83
!
3 UGI Gas Services 147.54
I '
I TOTAL (Also enter on line 10, Recapitulation) $ 196.45
, (If more space is needed, insert additional sheets of the same size)
CopyNght c 1996 form software only CPSystems, Inc. Form REV-1512 EX {Rev. I g7
REV- 1513 EX + (9-00}
COMMONWEALTH OI PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECED ENT~
ESTATE OF I 1
Alfred W. Stine SS~/ 161-18-0405
NUMBER
2
3
SCHEDULE J
BENEFICIARIES
01/29/2004
NAME AND ADDRESS OF PERSON S RECE V NG PROPERTY
TAXABLE O STRIBUT ONS [Inctude outright spou~l distribution, and
transfers under Sec' 9116(aX1'2)]
Nancy C~aine'
1883 Esther Drive
Carlisle, PAl 17013
Carlisli, PA/ 17013
Carlisl~ PA 17013
I1.
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Daughter
Daughter
FILE NUMBER
21-04-
Son
AMOUNT OR SHARE
OF ESTATE
1/3 remainder
1/3 remainder
1/3 remainder
ENTER DOLLA AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN, 15 THRU 18. AS APPROPRIATE, ON REV 1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MA~3E
B, CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET
0.00
(if more space is needed, [nser~ additional sheets of the same size)
Copyright (c) 2000 form software only ~he Lack~r Group, Inc. Form REV-1513 EX (Rev. 9-00)
I, ALFRED W. STiI~E, of the Bor6ugh of Carlisle, Cumberland
County, Pennsylvania, declare this 'instrument to be my last will
and tas~am_nr, hereby expless~y revoking ali wills and codicils
her(:tofore mada by me.
/
]. /I direct my executrix to pay all of my debts, funeral
and admi6istrative expenses as soon as may be done conveniently
I
afl:er my decease.
ex~cu,.rlx to sell any realty
2. authorize and empower my ' ~ ~ '
owned/ by me at my death, and not specifically devised or
beque-:the here.in, at either publia or private sale, and to give
good Jand sJfficient de~ds therefor, in fee simple,
iF
and
shal 1
davis
situat
childr!n
WOUIu ]ave
5. i
as I couid do
3. I devise and bequeath al! of my estate of every nature
herever situate Lo my wife, Edna Mae Stine, providing she
~urvive me by sixty days.
Should '[he gift in Paragraph No. 3 not taka effect,
.
and bequeath al! of my estate of every nature and wherever
to ~' ~hr~e childr~n share and ~h2rp c~llK~, +'~' ' ' '
,y ...... ~ . _ - "~ l.n. CF tlo or
parent
any deceased child taking Lhe share their
taken if
nominate and appoint E~m,.. Mae Stine to be Lhe
executi
such w'
refuse
ix of this my last. will and testament, she is to serve as
~.hou!,' ~ bond. Should she die before my dent. h,~ renounce or
to serve for any reason, or die leaving any of my estate
una( ,inistered, I nominate and appoint Augustus W. Stine,, as
substitute executor, also lo serve as such without bond, with
:he same >owers as are given .... ~i to my executrix.
the
sett'
this
hereby suggest that my personal representative retain
ervlces of Irwin,, Irwin & Irwin, as a~torneys in the
:men~. . of my estate.
...... , h .... un.o set my hand and seal
WITNESS wnER~uF I have ~ ~
~"~l day of ~ay, 1985.
_(S AL)
LFRED'W. SlINE
Si ned,' sealed, published and declared by Alfred W.
I
Stin~ theI above named testator, as and for his last will and
te ,.~l,=-n.~, ~n ~h~ presence of us, ~no his redt~es~,, in his
presence and in the presence of each other have subscribed, our
AuK 16~LEOG~ .cl.T Alii] AFFIDAVIT
~,LFkED ~. STIi'~E, BETZi A. I~,ORRISC'll and SH, RuN L.
SCH~L~LN the testator and tre witnesses, respectively, whose
n,--~mes are signed to the fore~joing instrument, being first duly
sworn, do hereby declare to ~he undersigned authority that the
~s~,~or ~igned and executed the instrunent as h~s Last: Will and
that ~e h~d sig.ned willingly, and that he executed it as his free
and zoluntary act for the purpose therein expressed, a~d ti~at
the
of¸
of
each of /the witnesses, in the presence and hearing of /
their/ Knowledge the testator was at that time eighteen
years
age or oider, of sound mind and under no undue influence.
ALFR~D W. STiI.!E
BE, Z.~/A
CO~iMONWEAL~H OF PEN?~SYLVI~IA :
I : SS:
COUNi-Y OF ~tIBERLA,q6 :
ALFRED
before
th~s 3
Subscribed, sworn to and acknowledged before rit~ by
STINE, the testator, and subscrihed ~nd sworn ~o
BETZI A. HORRJSON, and SUA~ON L. SCHWAL;t ~dtnesses
day of Nay, 1985.
~i¥ CO~41~ISStO~ EXPIR[$ OCL 3! ~988
Irwin & McK, night
Attorneys At ILaw I
West Pomfret~ Professional Building
60 West Pomfret Street
Carlisle, PA 1~7013-3222
IRe: Estate of Alfred W. Stine
Social Security: 161-18-0405
Date of Death: January 29, 2004
Phone (888) 502-4349
Fax (302) 934-2955
~-cB 25 2004
IRV qN & McKNIGHT
Dear Irwin:
Per your inquiry .ted February 112004 please be advised that at the time of death, the above-named decedent had on
deposit with this bank the following:
1. Savings Account
015004200932067
, Alfred WStine
Augustus W Stine
Opening 12/01/75
Balance, f Death
Accrued lnterest
Total
Type of A, fount
Account Number
Ownershil (Nam!s oJ)
$11,340.86
$ 2.71
$ll,343.57
Savings Account
025004910560801
Alfred W Stine
11/07/02
$320.11
Accruedb erest
Total
$ 0.00
$320.
Please be advi !d the e was no safe deposit box found for the above decedent:
For further account infl "marion, closures and/or mimbumement of funds please call the
High Street Carli!le Offi!e at#717-240-4536.
Sincerely,
Records Manag~ nt !
March 1~ 200
IRWIN & ,MCKN,IGHT LAW
ATTN ROGER IRWIN
WEST PO',MFRC:T PROF BLDG
60 WEST POM; RET ST
CARLISLE~ PA ;'013
Subject: 2nnui
Dear Mr. I ~nNin
Weslern-Soulhern Life'
Contract Number W0020696208 Alfred Stine
t ou, rPlease sympathy for the death of Alfred Stine. We hope the following
informa' ' helpful.
/
Our recordts indiciate the beneficiaries are as follows: Elenora McGowen, Augustus Stine
and Nancy ,Crain~. They each have the following options:
· We can/pay the death benefit in a lump sum now or no later than December 31,
2009. / · .
· We can~pay t ~e death benefit as an annuity (more than one payment), ir you
choose ~his o ~tion within one year from the date of the owner's death and payments
do not e'xcee~J the beneficiary's life'expectancy.
Please cOmplete the enclosed death claim form where indicated. Please return the form
with a certified c(~py of the death certificate. '
/
As of Januak 29,!2004, the date of death value was estimated to be approximately
$13,565.00.
When we receive this information, we will give our prompt attention to this claim. If you
have quesbons, please contact the sales representabve or our Annuity Operabons
Department at 1-800-926-1702. A representative wdl be happy to assist you.
Lois J Craft
Annuity Administrator
Annuity Operabons Department
l A ./0 . P.O. Box 2918 · Cincinnati, OH · 45201-2918
nnu~ty perabons Group ·
COM. MONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
RE,,CEIVED FROM:
-'~.-' IRWIN ROGER B
"u.,' 60 W POMFRET
: ' CARLISLE, PA
ESQ
ST
17013
L
ESTATE INFORMATION! SSN: 161-18-0405
FILE NUMBER: 2104-0333
'D~CEDENT NAME: STI'NE ALFRED W
DATE OF'PAYMENT: 04~06/2004
~OSTMARK DATE: oo/bo/oooo
C'OUNTY: CUMBERLAND
DATE OF DEATH: 01/1129/2004 ,
YEMARKS:
SEAL
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
M&T B~ NK
~HECK# 0368938
10-7
TOTAL AMOUNT PAID:
INITIALS: VZ
RECEIVED BY:
REGISTER OF WILLS
REV-1162 EX(11-96)
NO. CD 003768
AMOUNT
ACN
ASSESSMENT
CONTROL
NUMBER
101 $568.92
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
$568.92
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
ALFRED W. STINE
Date of Death:
JANUARY 29, 2004
No. 21-04-00333
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following
with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete: X Yes __ No
2. If the answer is No, state when the personal representative reasonably believes that the
administration will be complete:
3. If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes X No
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal representative state an account informally to the parties
in interest? X Yes No
do
Date: 08/24/2004
Copies of receipts, releases, joinders and approvals of formal or informal
accounts may be filed with the Clerk of Orphan's Court and may be
attached to this report.
SilnawtUre/'IN & &IGHT
Roger B. Irwin, Esquire
Name (please type or print)
60 West Pomfret Street
Address
Carlisle, PA 17013
City, State, Zip
(717) 249-2353
Telephone Number
Capacity:
X
Personal Representative
Counsel for Personal Representative
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENTOFREVENUE
BUREAU OFINDIV~DUAL TAXES
DEPT. 2$O601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX(11-96)
NO. CD 004369
STINE AUGUSTUS W
13 NORTHVIEW DRIVE
CARLISLE, PA 17013
fold
fESTATE INFORMATION: SSN: 161-18-0405
FILE NUMBER:
/ DECEDENT NAME:
2104-0333
STINE ALFRED W
DATE OF PAYMENT: 09/1 3/2004
POSTMARK DATE: 09/1 0/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 01/29/2004
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $598.86
TOTAL AMOUNT PAID:
9598.86
REMARKS:
SEAL
CHECK# 41 64
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
ROGER B IRWIN
IRWIN & MCKNIGHT
60 W POMFRET ST
CARLISLE
PA 17015
CONNONWEALTH OF PENNSYLVANTA
DEPARTHENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAZSENENT, ALLO~/ANCE OR DTSALLONANCE
OF DEDUCTTONS AND ASSESSNENT OF TAX
/)ATE OF DEATH
FILE NUHBER
ACN
08-16-2004
STINE
01-29-2004
21 04-0S$$
CUNBERLAND
101
ALFRED W
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 1701S
~T ALON~.TMZS LZNE ~ RETAZN LOWER PORTION FOR YOUR RECORDS
DZSALLOWANGE OF DEDUCTIONS AND ASSESSNENT OF TAX
ESTATE OF STINE ALFRED W FILE NO. 21 0q-0~$S ACN iOI DATE 08-16-2004
TAX RETURN ~/AS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Es~a~e (Schedule A)
2. S~ocks and Bonds (Schedule B)
3. Closely Held S~ock/Par~nership Znteres~ (ScheduZe C)
q. Hor~gages/No~es Receivable (Schedule D)
$. Cash/Bank Oepos~s/Htsc. Personal Proper~y (Schedule E)
6. Jotntly O~d Proper~y (Schedul~ F)
7. Transfers (Schedul~ G)
8. To~81 Asse~s
APPROVED DEDUCTIONS AND EXENPTIONS:
9. Funeral Expenses/Adm. Cos~s/Htsc. Expenses (ScheduZe H)
10. Deb~s/Hortgage L~ab~li~ies/L1ens (Schedule ~)
11. To'al Deductions
12. N~ Value of Tax Re~urn
(1) .00
(2) .00
($) .00
iq) .00
(,;) 320.11
(&) 5~671.79
(7) 15~565.00
(8)
6,052.50
(9)
(10) ~96.45
(11)
(1~)
13.
NOTE:
Char~able/Governmen~al Beques~s$ Non-elected 9115 Trusts (Schedule J) (13)
Ne~ Valu~ of Es~a~e Sub.~ec~ ~o Tax (lq}
Z~ an assessment was issued prev/ously, 1/nes 14, 15 and/ar 16, 17,
re~=lect figures that tncZude the total of ALL returns assessed ta date.
NOTE: To tnsure proper
credl~ ~o your account,
subel~ ~he upper por~ion
~ax payment.
ASSESSHENT OF TAX:
15. Amoun~ of L~ne 1~ a~ Spousal ra~e (1~)
16. Amou~ of Line 1~ taxable a~ Lineal/Class A ra~e (16)
19,556.90
6.~a.q~
15,$07.95
.00
13,307.95
18 and 19
.00 x O0 .00
13,507.95 x 045= 598.86
.00 x 12 .00
.00 x 15 .00
(19)= 598,86
CAX CREDITS:
04-06-200~t CD005768 29.9~ 568.92
TOTAL TAX CREDZT 598.86
BALANCE OF TAX DUE .00
.00
ZNTEREST AND PEN.
TOTAL DUE
.00
ZF PAZD AFTER DATE ZNDZCATED~ SEE REVERSE ( ZF TOTAL DUE ZS LESS THAN ~1, NO PAYHENT ZS REQUIRED.
FOR CALCULATION DF ADDITIONAL ZNTEREST. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT' (CR)~ YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
Ot~: Z d £ l d3,S ~0.
USA
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
CONNONWEALTH OF PENNSYLVANIA
DEPARTNENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
ROGER B IRWIN
IRWIN 8 MCKNIGHT
60 W POMF~T ST
C~L~SLE ~ ~i :~PA 1701:3
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
08-16-200q
STINE ALFRED W
01-29-200q
21
CUHBERLAND
101
Amount Rem/fred
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
; .... ':~' ~ ; CARLISLE, PA 1701:3
CUT ALO~'{~H'rS L~NE ~* RETAIN LOWER PORTION FOR YOUR RECORDS --~
~ !-~ ~)XSALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF STINE *r',)~ ALFRED W FILE NO. 21 0q--0:3:3:3 ACN 101 DATE 08--16--200~
TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST ' SEE REVERSF
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
$. Closely Held Stock/Partnership Interest (Schedule C) ($)
~. Mortgages/Notes Receivable (Schedule D) (~)
S. Cash/Bank Daposits/Hisc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expanses/Adm. Costs~Misc. Expenses (Schedule H) (9)
10. Dabts/Hortgage Liabilitles/Lians (Schedule 1) (10)
11. Total Deductions
12. Net Value of Tax Return
$20.11
.00 NOTE: To insure proper
.00 credit to your account,
.00 subalt the upper port/on
.00 of thls form with your
tax payment.
5z671.79
1:3z565.00
(8)
19,556.90
15.
1~.
NOTE:
ASSESSMENT OF TAX:
1.6. Amount of L/ne 1~ mt Spousal rata
16. Amount of Line lfi taxable at Lineal~Class A rate
17. Aeount of Line l~t et Sibling rate
18. Amount of Line 1~ taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDITS:
PAYHENT REC~/PT DISCOUNT
DATE NUHBER TNTEREST/PEN PAID (-)
O~-06-ZOOq CD00:3768 29.9~
6,052.50
196 .q5
(11)
(12) 15,$07.95
Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (1:5) .00
Nat Value of Estate Subject ~o Tax (lq) 1:3,:307.95
Zf an assessment ~as issued previously, lines 1~, 15 and/er 16, 17, 18 and 19 ~ill
reflect figures that include the total of ALL returns assessed to date.
(1.6) .00 X O0 = .00
(16) 1:5,307.95 X 0~5 = 598.86
(17) .00 x 12 = .00
(18) .00 x 15 = .00
(19)= 598.86
AMOUNT PAID
IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
568.92
TOTAL TAX CREDIT J 598.86
BALANCE OF TAX DUEI .00
~NTEREST AND PEN. I .00
TOTAL DUE I .00
( IF TOTAL DUE 1S LESS THAN $1, NO PAYMENT 1S REQUIRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE S/DE OF THIS FORH FOR INSTRUCTIONS.)
RESERVATION: Estates of decedents dying on ar before December 1Z, 198Z -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life ar for years, the Coeaonaealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the tawfuZ Class B (collateral) rate on any such future interest.
PURPOSE OF
NOTICE:
PAYHENT:
--Hake check or money order payable to: REGISTER OF #ILLS, AGENT
REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1513). Applications are available at the Office
of the Register of Hills, any of the Z5 Revenue District Offices, or by calling the special Z~-hour
answering service for forms ordering: 1-800-56Z-Z050; services for taxpayers aith special hearing and / or
speaking needs: 1-800-~7-50Z0 (TT only).
OBJECTIONS: Any party in interest not satisfied aith the appraisement, allowance, or disalloaanca of deductions, or assessment
of tax (including discount or interest) as sheen on this Notice must object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. Z81021, Harrisburg, PA 171ZB-lOZ1,
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
AONIR-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
To fulfill the requirements of Section ZI~O of the Inheritance and Estate Tax Act, Act 25 of ZOO0. (TI P.S.
Section 91~0).
Detach the top portion of this Notice and submit aith your payment to the Register of Hills printed on the reverse side.
Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Dureau of Individual Taxes, ATTN: Post Assessment Review Unit, Depto Ia0601, Harrisburg, PA 171Z8-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-IS01) for an explanation of administratively correctable errors.
Xf any tax due is paid within three (5) calendar months after the dacadent's death, a five percent (5X) discount of
the tax paid is allowed.
The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the and of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquency, or nine (9) months and one fl) day from the date of
death, to the date of payment. Taxes which became delinquent before January l, 19az bear interest at the rate of
six (eX) percent per annum calculated at a daily rate of .00016~. All taxes ahich became delinquent on and after
January 1, 198Z will bear interest at a rate which wi1! vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through ZO0~ ara:
Interest Daily Interest Daily Interest
Daily
Rate Factor
9X .O00Z~7
6Z .00016~
5Z .000137
~X .000110
Year Rate Factor Year Rate Factor Year
~'~ ZOZ .0005q8 ~'~'~6-1991 11Z .000301 ~
1985 lex .000~58 1992 9Z .O00Z~7 ZOOZ
198~ 112 .000301 1995-199~ 72 .O0019Z 2003
1985 13Z .000556 1995-1998 9Z .0002~7 ZO0~
1986 lOZ .00027~ 1999 7Z .OOOleZ
1987 lOX .OOOZT~ ZOO0 72 o00019Z
--Interest is calculated as folloas:
TNTEREST = BALANCE OF TAX UNPA'rD X NUNBER OF DAYS DBLTNQUENT X DA'rLy XNTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond the date of the assessment, if payment is made after the interest computation date sheen on the
Notice, additional interest must be calculated.
OR